Expression And Significance Of ACAT1 In Endometrial Adenocarcinoma

Endometrioid adenocarcinoma is a malignant tumor formed by excessive endometrial hyperplasia under the long-term stimulation of estrogen.It belongs to estrogen-dependent(type I)endometrial carcinoma,which is more common in perimenopause and postmenopausal women,and generally is well-differentiated and has a good prognosis.Obesity,hypertension and diabetes are high risk factors of I type endometrial carcinoma,so metabolism is an important factor affecting the incidence of endometrioid adenocarcinoma.Cholesterol is the main component of blood fat,its metabolism affects the level of blood fat,resulting in fat,atherosclerosis.It also can participate in the regulation of the expression of estrogen as the main component of estrogen synthesis.Therefore,cholesterol metabolism may affect the development of endometrioid adenocarcinoma.Acetyl-Coenzyme A acetyltransferase(ACAT)is an enzyme that catalyzes the formation of cholesterol esters from cholesterol and long-chain fatty acids,and is involved in the absorption,transport and storage of cholesterol.Acetyl-Coenzyme A acetyltransferase-1(ACAT1)is one of the isoenzymes of ACAT,which exists in almost all body.Currently,there have been literatures proving that ACAT1 is related to the immunotherapy of prostate cancer,breast cancer,colorectal cancer and other tumors.Studies have shown that the high expression of ACAT1 can lead to the reduction of cellular cholesterol,inhibiting the recognition between immune cells and cytotoxicity,and cause tumor escape.ACAT1 can inhibit the activation of pyruvate dehydrogenase complex(PDC),promoting tumor cells to obtain energy through glycolysis,and finally causethe formation of tumors.ACAT1 regulates cholesterol levels,which is involved in estrogen synthesis.So far,domestic and foreign scholars have explored more about the expression and pathogenesis of ACAT1 in other diseases such as coronary atherosclerosis,prostate cancer or any other cancers,but few studies have been conducted on endometrioid adenocarcinoma.Carrying out experimentswith the method of immunohistochemistry and PCRto test the expression of ACAT1 in endometrioid adenocarcinoma and normal endometrium as well as analyzing the differences of expression of ACAT1 could explore the role of ACAT1 in the formationof endometrioid adenocarcinoma and provide new ideas for the pathogenesis and treatment ofendometrioid adenocarcinomaObjectives:Detect the expression of ACAT1 in the endometrium of patients with endometrioid adenocarcinomaand normal endometrium of patients without endometrial carcinoma and compare the differences of the expression of ACAT1.Explore the significance of ACAT1 in endometrioid adenocarcinoma and provide a new idea for the conservative treatment.Method:The experimental group was the endometriun of endometrioid adenocarcinoma patients,and the control group was the normal endometriun of patients undergoing surgery for uterine fibroids.Immunohistochemistry and real-time quantitative PCR were used to detect the expression of ACAT1,and SPSS 22.0 was used for statistical analysis.Resu ts:1.ACAT1 was expressed in glandular cells and interstitial cells in the control group,and the expression was negative or weakly positive.The expression of ACAT1 in glandular cells was higher than interstitial cells,and the expression in the proliferative phase of endometrium was higher than that in the secretory phase.The scores of ACAT1 in secretion phase and hyperplasia phase were respectively 2.68�1.96 and 3.70�1.55(P<0.05).2.ACAT1 was expressed in glandular cells and interstitial cells of the experimental group,and the expression was mainly positive or strongly positive.The expression of glandular cells was higher than that of mesenchymal cells.endometrioid adenocarcinoma was divided into high differentiation,medium differentiation and low differentiation according to the degree of differentiation.The staining scores wererespectively 6.71�2.91,7.71�2.67 and 7.56�2.04(P>0.05).endometrioid adenocarcinomawas divided into three groups by stage,la,lband ?,and ?,and the staining scores were respectively 6.86�2.79,6.89�2.24,and 8.78�2.47(P<0.05).3.The staining score of the experimental group was 7.22�2.70,and that of the control group was 3.21�1.81(P<0.01),and the difference was statistically significant.PCR showed that the expression level of ACAT1 in endometrioid adenocarcinoma was 1.67 times higher than that control group(P<0.05).Conclusion:1.ACAT1 is expressed in both glandular cells and stromal cells of the normal endometrium.The expression of ACTA1 in glandular cells is higher than that of stromal cells,and the expression of normal endometrium in the proliferative phase is higher than that in the secretory phase.This indicated that the expression of ACAT1 in normal endometrial tissue was periodic.2.ACAT1 is expressed in both glandular cells and stromal cells of endometrioid adenocarcinoma,and the expression of ACAT1 in glandular cells is higher than that in stromal cells.The expression of ACAT1 was not related to the histological differentiation,but positively correlated with the staging of endometrioid adenocarcinoma,suggesting that ACAT1 may be involved in the development of endometrioid adenocarcinoma.3.The expression of ACAT1 in endometrioid adenocarcinoma is higher than that in normal endometrium,suggesting that ACAT1 is related to the occurrence of endometrioid adenocarcinoma.